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Individual

DEBORAH CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1219 DUNN AVE, DAYTONA BEACH, FL 32114-2405
(386) 255-4568
Mailing address
2244 JUANITA DR, NEW SMYRNA BEACH, FL 32168-8491
(386) 423-5187

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
403
FL

Other

Enumeration date
01/23/2007
Last updated
07/08/2007
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